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Kid Doc Talk: Concussions
by Dr. Janet Grabowski
Q. My 8-year-old plays several team sports and sometimes the games involve some rough tackling. Is there a safety risk I should know about?
A. Any blow to the head, face or neck, or somewhere else on the body that causes a sudden jarring of the head may cause a concussion, such as being hit in the head with a ball or being checked into the boards in hockey.
A concussion is a brain injury that affects the way you think and remember things for a short time. It can cause many signs and symptoms which may not necessarily be seen on X-rays or C.T. scans.
A person does not need to be knocked out (lose consciousness or pass out) to have had a concussion.
If your child has a concussion
He should stop playing the sport right away. Do not leave him alone. A doctor should see him as soon as possible that day. If your child is knocked out, call an ambulance to go to a hospital immediately. Do not move your child or remove sport equipment like the helmet. Wait for the paramedics to arrive.
The signs and symptoms of concussion often last for 7 to 10 days but may last much longer. In some cases, children may take many weeks or months to heal. A child who has had a concussion before may take longer to heal.
The most important treatment for a concussion is rest. That means not exercising, bike riding, play wrestling with family or friends, playing video games or working on the computer. Your child may have to stay home from school because schoolwork may make their symptoms worse. If your child goes back to school or resumes activities before he is completely better, he is more likely to get worse and to have symptoms longer.
Even though it is very hard for an active child to rest, this is the most important step. Once your child is completely better at rest, he can start to gradually increase his activities. It's important to see a doctor before returning to activity to ensure that he is completely better.
Sometimes children who have a concussion find it hard to concentrate in school, and may get a worse headache or feel sick to their stomach if they try to learn. Children should stay home from school if their symptoms get worse while they are in class. Once they feel better, they can try going back to school for half days at first. If they are okay with that, then they may go back full time.
Children should not go back to sports if they have any concussion symptoms or signs. They must rest until they are completely back to normal. After they have been back to normal and have been seen by a doctor, they can then go through these steps to gradually increase activity:
- Complete rest until all symptoms have gotten better.
- Light exercise, such as walking or stationary cycling, for 10 min to 15 min.
- Try a sport-specific activity (such as skating in hockey or running in soccer) for 20 min to 30 min.
- Move to 'on field' practice, such as ball drills, shooting drills and other activities with no contact (for example, no checking and no heading the ball).
- Once cleared by a doctor, move to 'on field' practice with body contact.
- Game play.
Note: Each step must take at least one day. If a child has any symptoms of a concussion (headache or feeling sick to the stomach) that come back during the activity, he should stop the activity immediately and rest for 24 h to 48 h. The child should be seen by a doctor and cleared before starting the stepwise plan again.
If your child gets a head injury, he should be seen by a doctor as soon as possible. If your son has been diagnosed with a concussion he should see a doctor immediately if symptoms get worse, such as:
- being more confused;
- worsening of a headache;
- vomiting more than once;
- not waking up;
- having trouble walking;
- experiencing a seizure; or
- behaving strangely.
Problems caused by a head injury can get worse later that day or night. Your son should not be left alone and should be checked on through the night.
If there are any concerns about a child's breathing or sleep, wake him up. Otherwise, let him sleep. If he seems to be getting worse, see a doctor immediately. No child should go back to a sport until they have been cleared to do so by a doctor.
Dr. Janet Grabowski is a paediatrician in Winnipeg. She is a member of the Canadian Paediatric Society's Board of Directors.
For more information on your child's growth and development, visit the Canadian Paediatric Society's Web site in either English* or French.* (* Will open in a new window.)
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Kid Doc Talk: Concussions
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